SHANE S SPICER Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036112321

License Status

NOT RENEWED

Business

First Name

SHANE

Middle

Last Name

SPICER

Business Name

SHANE S SPICER

Original Issue Date

09/13/2004

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

NEW YORK CITY

State

Zip

10023

Ever Disciplined

LastModifiedDate

11/06/2008